Dental appliance

ABSTRACT

Embodiments include dental appliances, dental appliance systems, and methods of making and using such appliances. In one embodiment, a dental appliance includes a shell having a number of cavities to receive one or more teeth, each cavity having an inner surface. Fewer than all cavities are scaled-up in size by a first selected percentage over one or more dimensions of a corresponding tooth surface to provide a uniform space between the cavity inner surface and the corresponding tooth surface.

PRIORITY INFORMATION

This application is a Continuation of U.S. application Ser. No.13/466,874, filed May 8, 2012, which is a Divisional of U.S. applicationSer. No. 12/157,670, filed Jun. 12, 2008, now U.S. Pat. No. 8,172,569,the entirety of which are incorporated herein by reference.

BACKGROUND

The present disclosure is related generally to the field of chemicallytreating individual teeth and/or associated gingival areas. Moreparticularly, the present disclosure is related to chemically treatingindividual teeth and/or associated gingival areas during the course ofdental alignment.

Repositioning teeth for aesthetic or other reasons has been accomplishedby wearing what are commonly referred to as “braces.” Braces typicallyencompass a variety of hardware such as brackets, archwires, ligatures,and O-rings. Attaching the hardware to a patient's teeth can be atedious and time-consuming task requiring multiple meetings with atreatment professional.

Further, braces are attached to the surfaces of the teeth and sincethese surfaces are not exposed to food, drink, and other items whilethey are covered by the braces, oftentimes, the covered portion can havea different coloration when the braces are removed. This can benoticeable in some instances and since only a portion of the teeth is adifferent cooler, it can be difficult to remedy.

Moreover, from the patient's perspective, the use of braces can also beunsightly, uncomfortable, present a risk of infection, and can hindereffective brushing, flossing, and/or use of other dental hygieneprocedures. Furthermore, in some instances, the use of braces caninterfere with, or delay, other dental treatment of one or more teeth.

For example, application of whitening chemicals may not be effectivewhile brackets are in place since the portion of tooth surface under thebrackets can be left untreated, and thus be discolored with respect tothe exposed tooth surface. Similarly, fluoride treatments may not reachthe entire tooth structure.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A illustrates an example of a patient's dentition and a digitalrepresentation of the patient's dentition that can be used to form adental positioning appliance according to an embodiment of the presentdisclosure.

FIG. 1B illustrates an example of a cross section of the dentition thatcan be derived based on FIG. 1A (e.g., line 1B-1B), according to anembodiment of the present disclosure.

FIG. 2 illustrates an example of a scaled-up cavity of a dentalappliance according to an embodiment of the present disclosure.

FIG. 3 illustrates another example of a scaled-up cavity of a dentalappliance, the cavity having spacers, according to an embodiment of thepresent disclosure.

FIG. 4 illustrates an example of an appliance having one or morescaled-up cavities for selected teeth according to an embodiment of thepresent disclosure.

FIG. 5 illustrates an example of a scaled-up cavity of an appliance,including a pocket surrounding the gingiva, according to an embodimentof the present disclosure.

FIG. 6 illustrates an example of an appliance having one or morescaled-up cavities for selected teeth according to an embodiment of thepresent disclosure.

DETAILED DESCRIPTION

Embodiments of the present disclosure provide appliances, system andmethods of making and using such appliances and/or systems. In variousembodiments, a dental appliance, for example, can include a shell havinga number of cavities to receive one or more teeth, each cavity having aninner surface. In some embodiments, fewer than all of the cavities arescaled-up in size by a first selected percentage over dimensions of acorresponding tooth surface to provide a uniform space between thecavity inner surface and the corresponding tooth surface.

Embodiments of the present disclosure are described in relation to theaccompanying drawings, which will at least assist in illustrating thevarious features of the various embodiments. In the Figures, the firstdigit of a reference number refers to the Figure in which it is used,while the remaining two digits of the reference number refer to the sameor equivalent parts of embodiment(s) of the present disclosure usedthroughout the several figures of the drawing. The scaling of thefigures does not represent precise dimensions and/or dimensional ratiosof the various elements illustrated herein.

Many dental treatments involve repositioning misaligned teeth andchanging bite configurations for improved cosmetic appearance and dentalfunction. Repositioning can be accomplished, for example, by applyingcontrolled forces to one or more teeth over a period of time. Somedental processes use dental positioning appliances, rather than braces,for realigning teeth. Such appliances may, for example, utilize a thinshell of material having resilient properties, referred to as an“aligner” that generally conforms to a patient's teeth but is slightlyout of alignment with the present (e.g., initial) tooth configuration.

Placement of such an appliance over the teeth provides controlled forcesin specific locations to gradually move the teeth into a newconfiguration. Repetition of this process with successive appliancesthat provide progressive configurations eventually move the teeththrough a series of intermediate arrangements to a final desiredarrangement. An example of such a system is described in U.S. Pat. No.5,975,893.

Such systems generally rely on designing and fabricating some, most, orall of the appliances, to be worn by the patient over time, at theoutset of treatment. In some processes the design of the appliancesrelies on computer modeling of a series of successive tooth arrangementsand the individual appliances are designed to be worn over the teeth andto reposition the teeth by using the appliances in a serial order,progressing from a first appliance, through each of the intermediateappliances, to the last appliance.

Appliances according to embodiments of the present disclosure may alsobe fabricated to conform to, or maintain, the present position of thepatient's current dentition, and may, but do not have to, impart forceto any of the teeth (e.g., for re-positioning). As such, the appliancemay serve as a tray, or retainer, for delivery of material to one ormore teeth without intended accompanying dental treatment functionality.

FIG. 1A illustrates an example of a patient's dentition and a digitalrepresentation of the patient's dentition that can be used to form adental positioning appliance according to an embodiment of the presentdisclosure. In various embodiments, an impression of the patient's teeth100 can be taken with various impression materials. The impression ofthe patient's teeth 100 can then be scanned and the data gathered by thescan can then be used to form a digital model of the impression ofpatient's teeth 101.

The digital model of the impression of the patient's teeth 101 can, forexample, provide a digital image of the patient's teeth that maps theoutside surface of the impression of the patient's teeth 100 to allow360° viewing the patient's teeth. The patient's teeth can also bescanned directly to form the digital model.

The digital model 101 may be further determined from additionalmeasurements of a patients dentition. Surveying of the positioning of apatient's teeth within a mouth of a patient can, for example, beaccomplished by manually taking a set of one or more data points by atreatment professional to determine gum line, or attachment pointposition, the data points then being entered into a computing device.

Data can also be obtained through an automated or semi-automatedprocess. Further, a size and/or shape of an erupting tooth (teeth) canbe estimated, for example, through use of a library of tooth sizesand/or shapes and/or information about the patient's other teeth. Thisinformation can be provided manually by a treatment professional or byan automated or semi-automated process in various embodiments.

Once obtained, the digital model 101 can then be studied by a treatmentprofessional to determine if a dental condition exists with thepatient's teeth. In some instances, the configuration of a patient'steeth can be studied easier and more thoroughly, for longer timeperiods, than can be achieved looking into the mouth of the patientwhile the patient is at the treatment professional office. The digitalmodel 101 can also be used to fabricate a dental appliance correspondingto a present, anticipated, and/or desired configuration of the patient'sdentition.

FIG. 1B illustrates an example of a cross section of the dentition thatcan be derived based on FIG. 1A (e.g., line 1B-1B), according to anembodiment of the present disclosure. In various embodiments, thedigital model 101 of the impression of the patient's teeth can be viewedin cross section 103. This view can be beneficial to the treatmentprofessional in evaluating the patient's teeth and diagnosing andforming a treatment plan for an orthodontic condition of the patient.The cross sectional view 103 of the digital model of the patient's teethcan provide a unique perspective of the patient's teeth that is notavailable through other processes, such as visual inspection or picturesof the patient's teeth.

A dental positioning appliance (e.g., an aligner) can be electronicallyderived from the digital model 101 of patient's teeth, and/ormanipulations thereof, according to various embodiments of the presentdisclosure. A dental appliance includes multiple cavities for receivingone or more corresponding teeth.

A dental appliance generally conforms to a patient's teeth, but may beslightly out of alignment with respect to a given configuration of apatient's teeth. From the digital model 101, manipulations (e.g.,movements) of individual teeth, or groups of teeth can be electronicallymodeled, such as by studying the effects of applying certain forces tovarious teeth. However, the dental appliance need not be out ofalignment with a given configuration of the patient's teeth if notneeded for treatment.

According to one or more embodiments of the present disclosure, a dentalappliance such as an aligner, or tray, includes a number of cavities(e.g., cavity 204). The cavities generally correspond to one, but maycorrespond to multiple, individual teeth, and/or other features of apatient's dentition.

The dental appliance can be fabricated from a polymeric shell, or formedfrom some other material, and include a number of cavities shaped toreceive corresponding teeth. The shell may be designed to fit over anumber of, in many instances all teeth, present in the upper or lowerjaw. Dental appliances can be configured to apply force to repositionone or more teeth from a first configuration of the teeth to asuccessive configuration of the teeth.

Various aspects of a digital model of a patient's teeth can bemanipulated such as, for example, changing the size of individual teeth,or changing the size of a cavity corresponding to one or more particularteeth. One having ordinary skill in the art will appreciate that thesize of a cavity of a dental appliance corresponding to a particulartooth may be changed by modifying the size of the particular tooth inthe digital model of a patient's dentition, fabricating a physical modelfrom the digital model by any number of manufacturing techniques, andsubsequently forming a dental appliance from the physical model whichincludes the enlarged tooth.

In such embodiments, the size of a particular tooth may be changed byincreasing one tooth dimension (e.g., length or girth), or several toothdimensions simultaneously (e.g., length and girth). One methodology foruniformly increasing size of a particular tooth in the digital model isto scale-up selected tooth dimensions proportionately.

For example, some or all of the measured dimensions of a particulartooth may be uniformly increased in the digital model. Thus, a dentalappliance formed from that digital model will result in a buffer,cushion or gap created around the particular tooth.

Tooth size modifications may be applied to one or more teethsimultaneously in some embodiments. When applied to multiple teethsimultaneously, the size modifications to individual teeth may be allthe same. or selected to be different for one or more teeth.

The size of an individual tooth in a digital model, and/or thecorresponding tooth cavity in a dental appliance formed from the digitalmodel, may be modified from measured dimensions so as to be increased insize, or oversized, by a percentage of the original size, for example1%, or by some other scaling factor.

FIG. 2 illustrates an example of a scaled-up cavity 204 of a dentalappliance according to an embodiment of the present disclosure. In theembodiment of FIG. 2, a tooth structure 200 is partially surrounded by acorresponding gingival margin area 202.

As discussed above, the tooth structure 200 has a particular shape anddimensions which can be accurately determined in three-dimensional spaceby a number of methods, including the impression and digital modelingtechniques discussed with respect to FIGS. 1A and 1B. In the embodimentof FIG. 2, the cavity 204 of a dental appliance is shown fabricated todimensions which are scaled-up from the dimensions of the correspondingtooth structure 200 so as to provide a uniform space surrounding thetooth structure 200, as shown in cross section in FIG. 2.

When referring to “scaling-up” portions of the digital modes or theresulting shell/dental appliance, as used herein, the relativedimensions of portions of the model can be maintained. Thus, inscaling-up an individual tooth of the digital model, proportions of thetooth dimension are maintained relative to one another.

One skilled in the art will appreciate that a dental appliancefabricated based on a model having one or more oversized teeth willresult in a shell possessing the same, or similar, qualities. Certaincavities in the shell can therefore be made larger than thecorresponding actual tooth (teeth), thereby leaving a uniform space orgap between the actual tooth and the shell interior surfaces.

A uniform space surrounding a particular tooth, or teeth, may be boundedby the present position of other teeth. For example, in variousembodiments, a particular tooth may be scaled-up into available emptyspace, but not into space occupied by adjacent teeth.

According to some embodiments of the present disclosure, a particulartooth can be scaled-up in the digital model (and thus in thecorresponding dental appliance formed from such digital model) indirections other than toward adjacent teeth (e.g., in a buccal and/orlingual directions only). According to various embodiments, force can beapplied through the dental appliance to move adjacent teeth away fromspace allotted to a scaled-up tooth, or teeth.

Embodiments of the present disclosure are not limited to an “aligner”that is intentionally fabricated slightly out of alignment with thepresent tooth configuration so as to provide force to one or more teeth.As will be appreciated by the reader, a dental appliance according toembodiments of the present disclosure may conform to a patient's toothconfiguration. Thus, according to at least one embodiment of the presentdisclosure, a targeted tooth treatment and/or gingival treatment can beaccomplished concurrent with alignment treatment, or separate anddistinct from the alignment treatment.

Embodiments of the present disclosure include dental appliances, dentalappliance systems, and methods of making and using such appliancesand/or systems. In various embodiments, a dental appliance can include ashell having a number of cavities to receive one or more teeth, eachcavity having an inner surface.

In some embodiments, one or more, but less than all, cavities can bescaled-up in size (e.g., by a first selected percentage) over dimensionsof a corresponding tooth surface to provide a uniform space between thecavity inner surface and the corresponding tooth surface. The dentalappliance may, or may not, be designed for application on movingforce(s) to one or more teeth.

According to at least one embodiment of the present disclosure, a dentalappliance adapted to fit the present configuration of a patient's teethcan include one or more cavities scaled-up in size to provide a spacearound one or more selected teeth for containing a chemical in contactwith the one or more selected teeth. In such embodiments, at least onecavity corresponds in size to the measured dimensions of thecorresponding one or more teeth, and serves as an anchor for the dentalappliance to keep it located in a fixed orientation with respect to theteeth. Thus by having at least one such anchoring cavity snuggly fittedto one or more corresponding teeth, the spaces between one or moreoversized cavities of the dental appliance and one or more correspondingteeth can be maintained with reduced or minimal relative movement insome instances.

The present disclosure also includes a number of method embodiments. Forexample, in some embodiments, a method can include forming a removabledental appliance, such as a positioning appliance, which includesidentifying a first portion of a patients dentition for chemicaltreatment, and digitally measuring dimensions of the patient'sdentition.

A polymeric shell having a number of cavities shaped to receive thepatients teeth can be formed, with some of the cavities being sized tothe measured dimensions. Cavities corresponding to the identifiedportion of the dentition are fabricated having at least some dimensionslarger than the measured dimensions to provide space between the dentalpositioning appliance and a corresponding tooth structure (e.g., one ormore tooth surfaces of one or more teeth), the space adapted to containa quantity of chemical in contact with a corresponding dentition.

The devices, methods, or systems of the present disclosure can employany manner of positioners, trays, retainers, and/or other removabledental appliances for changing or maintaining teeth positions inconnection with orthodontic treatment, or separate from orthodontictreatment. The systems for use in various embodiments of the presentdisclosure can utilize a single appliance solely for application ofchemical treatment therapies, or a plurality of such appliances thatcan, for example, be worn by a patient successively in order to achievethe gradual tooth repositioning, as described herein.

In some embodiments, certain individual teeth, or small sets of theteeth, can be repositioned while others of the teeth provide a base oranchor region for holding the repositioning appliance in place as itapplies a resilient repositioning force against the tooth or teeth to berepositioned. In such cases, one or more of the teeth which are movedcan also serve as a base or anchor region for holding the repositioningappliance.

That is, the tooth and/or teeth cavities of the dental appliance whichare being moved or re-positioned may serve as anchor teeth for cavitiesof the dental appliance which are formed oversized (e.g., by scaling-up)for chemically treating one or more certain teeth. In some embodiments,the gums and/or the palette can serve as an anchor region, thus allowingall or nearly all of the teeth to be repositioned and/or chemicallytreated using oversized cavities in the dental appliance at the sametime, if desired.

The polymeric shell of the appliance may be a substantially transparentpolymeric shell, for example, but embodiments of the present disclosureare not so limited. In some embodiments of the present disclosure,buccal portions of the shell cavities can be formed from a substantiallytransparent material. Other portions of the shell and/or cavities may,or may not, be substantially transparent, substantially opaque, and/orformed of an opaque material.

With respect to the embodiment of FIG. 2, the oversized cavity 204 canbe fabricated for a particular tooth, chosen for example, as being inneed of dental treatment such whitening of the tooth structure,application of fluoride, and/or some other condition which can betreated by a chemical application. The size of the cavity 204 can bescaled-up to a selected size according to embodiments of the presentdisclosure, the selection being to any of: a particular dimension(s), aparticular scaling factor, to achieve particular gap or spacecharacteristics, etc.

For example, one or more cavities of the appliance may be scaled-up to afirst selected percentage in the range from 1% to 5% inclusive; howeverscaling up the appliance to the first selected percentage is not limitedto this range. For example, the first selected percentage may be lessthan 1%, or more than 5% when desired to achieve a particular treatmenteffect, or accommodate a certain chemical or solution.

According to at least one embodiment of the present disclosure, cavity204 is arranged to be scaled-up corresponding to only one side of acorresponding tooth surface, for example formed to leave a uniform spacebetween the inner cavity wall and a corresponding tooth surface (such asthe buccal surface), without being scaled-up to create a uniform spacebetween the inner cavity wall and other corresponding tooth surfaces(such as the lingual surface).

In some embodiments, the one or more cavities being individuallyscaled-up to dimensions larger than the measured dimensions of thecorresponding tooth may all be scaled-up to the same selectedpercentage, or may individually be scaled-up to an individually-selectedpercentage for each cavity, which may, or may not, be the same as aselected percentage for another cavity. As the reader will appreciate,some cavities may be scaled-up to provide a uniform space around acorresponding tooth, while the dimensions of other cavities are modifiedin ways other than scaling (e.g., increase in size along one dimensionor by some fixed amount, etc.). In some embodiments, the tip of thetooth may have scaling different from that of other portions of thetooth, or the scaling may vary (e.g., taper) smaller or larger from thetip of the tooth toward the root.

According various embodiments, one or more cavities are sized to containa chemical used to treat the corresponding tooth surface, such that thechemical remains in contact with the desired tooth surface. The one ormore cavities can be appropriately sized, for example, to accommodate achemical having a particular viscosity, to accommodate a particularquantity of chemical, and/or according to other properties of thematerial used to deliver the chemical and/or treatment considerations.For example, a selected percentage of a dental appliance cavity beingscaled-up may be approximately 1%, or less, when being adapted for usewith the chemical being fluoride, and a selected percentage of a dentalappliance cavity being scaled-up may be approximately 5%, or more, whenbeing adapted for use with the chemical being a whitening agent. Theselected percentage may be different for the respective chemicals of theabove-mentioned examples depending on the precise compound, or form, ofthe chemical delivery material (e.g., liquid, gel, powder, foam, etc.).

In general, appliance embodiments of the present disclosure have the oneor more cavities scaled-up in size to have a uniform space between atleast one inner cavity surface and the corresponding tooth surface. Thecorresponding tooth surface may be all of the exposed surfaces of aparticular tooth, for example in the case of cavity preventiontreatment, or the corresponding tooth surface may only be a buccal, orother, surface, for example in the case where the dental treatment iswhitening.

FIG. 3 illustrates an example of a scaled-up cavity of a dentalappliance, the cavity having spacers, according to an embodiment of thepresent disclosure. In one or more embodiments of the presentdisclosure, such as that partially illustrated in FIG. 3, a system ofremovable dental positioning appliances includes a series of shellsadapted to reposition one or more teeth from a first configuration to asuccessive configuration, each shall having a number of cavities toreceive one or more teeth and each cavity having an inner surface.

One or more of the cavities are scaled-up in size by a selectedpercentage over dimensions of a corresponding tooth surface to provide auniform space between the cavity inner surface and the correspondingtooth surface. The inner surface of the one or more cavities includespacers to offset the inner surface from the corresponding toothsurface. The reader will appreciate that such localized mechanicaloffsets, facilitate uniform distribution of chemical to thecorresponding tooth surface area.

In the embodiment of FIG. 3, a tooth structure 300 is partiallysurrounded by a corresponding gingival area 302, and the cavity 304 of adental appliance (e.g., shell) is scaled-up in the manner previouslydescribed above. A number of spacers 306 (e.g., one or more) protrudefrom the inner cavity surface toward the surface of the correspondingtooth 300. The spacers 306 extend for a distance above the inner cavitysurface substantially equal to the gap, or uniform space, between thesurface of the corresponding tooth 300 and inner surface of the cavity304. One skilled in the art will appreciate that the spacers 306 therebycan provide a mechanical offset to maintain space between the surface ofthe corresponding tooth 300 and inner surface of the cavity 304, in someembodiments.

According to one or more embodiments of the present disclosure, one ormore spacers 306 may be arranged to be in contact with at least onesurface of the corresponding tooth surface (e.g., a lingual surface asshown in FIG. 3). According to at least one embodiment of the presentdisclosure, the number of spacers are arranged to be in contact withmore than one surface of the corresponding tooth surface (e.g., a buccalsurface as well as the lingual surface).

Embodiments of the present disclosure are not limited to any particularquantity, orientation, arrangement, or pattern of spacers 306. Spacers306 may be of the same or different dimensions from one another (e.g.,may be of differing heights above the inner surface of the cavity 304,or all extending a uniform dimension above the inner surface of thecavity 304).

Spacers 306 may be uniformly arranged in various dimensions, or locatedin specified locations. Some oversized cavities may include spacers,while others do not.

Spacers need not be of the rounded shape shown in FIG. 3, and may beformed as an offset at a particular point, or as a ridge or othergeometry. The spacers need not be formed of additional material added tothe inner surface of the cavity 304, but rather may be formed by moldingthe cavity wall to provide the offset (e.g., the outer cavity wall mayhave a corresponding indentation corresponding to a spacer structure.

In some embodiments, a resilient material can be used to form at least aportion of a spacer structure. In such embodiments, the spacer maybeshaped, or otherwise designed, to provide the same, or different,amounts of force (e.g., as the chemical material in the appliance isremoved). One skilled in the art will appreciate the numerous ways thata physical offset may be fabricated as part of the dental appliance soas to provide a mechanical offset of a cavity inner wall from thecorresponding tooth surface.

FIG. 4 illustrates an example of a dental appliance having one or morescaled-up cavities for selected teeth according to an embodiment of thepresent disclosure. FIG. 4 shows a top view of a patient's dentition fitinto a dental appliance 404 according to one embodiment of the presentdisclosure. Illustrated are one or more treated teeth 400 positionedwithin one or more oversized (e.g., scaled-up) cavities 414 of thedental appliance 404, the treated teeth 400 having been selected forsome form of chemical treatment. Other teeth 401 are not being selectedto receive the aforementioned chemical treatment. The untreated teeth401 are shown positioned within more fitted (e.g., not scaled-up)cavities 412 of the dental appliance 404.

The reader will appreciate the dental appliance 404 is configured suchthat more space is left between the treated teeth 400 selected forchemical treatment and the corresponding oversized cavity 414 of thedental appliance, than the space, if any, between untreated teeth 401(e.g., not presently being chemically treated) and a correspondingfitted cavity 412 of the dental appliance 404. One skilled in the artwill appreciate that the close fitting cavities 412 of the dentalappliance 404 hold the dental appliance 404 in a fixed position, withrespect to the patients dentition, such that the oversized cavities 414of the dental appliance 404 are held in relative place around thetreated teeth 400. In this manner, a chemical placed within an oversizedcavity 414 is kept in contact with the treated teeth 400.

One or more teeth may be treated at one time. The treated teeth may (asis shown in FIG. 4), but need not be, adjacent one another. Theoversized cavities may also be used to relieve pressure on one or moreteeth, and thus the space left around a particular tooth need not befilled with a chemical in employing the dental appliance of the presentdisclosure.

One skilled in the art will also appreciate that some or all teeth maybe treated simultaneously, with the dental appliance formed to allowmore space around certain teeth than others. For example, it may beadvantageous to fabricate a dental appliance having additional fluidcapacity surrounding the two front teeth than around the remainingteeth, such as for whitening applications intended to target selectedteeth more vigorously than others.

FIG. 5 illustrates an example of a scaled-up cavity of an appliance,including a pocket surrounding the gingiva, according to an embodimentof the present disclosure. As shown in FIG. 5, a tooth structure 500 ispartially surrounded by a corresponding gingival margin area 502.

The exposed tooth structure can be enclosed by an oversized (e.g.,scaled-up) dental appliance cavity 504, which can be a portion of ashell as previously described above. According to various embodiments ofthe present disclosure, the cavity walls of the shell may extend up andover a corresponding gingival margin area 502 outer surface.

In a manner similar to the dental appliance cavity 504 surrounding thetooth surface, the shell may be fabricated to allow for a space betweenthe upper walls of a particular cavity, or the shell, and thecorresponding gingival margin area 502, so as to form a lingual, pocket508 and/or a buccal pocket 510 adapted to hold a chemical adjacent thecorresponding gingival margin area 502. In this manner, the dentalappliance can be used to chemically treat selected areas of the gingivalmargin area 502. According to at least one embodiment of the presentdisclosure, the lingual pocket 508 and/or buccal pocket 510 areas can becontiguous with cavity 504.

Like the tooth structure itself, measurements with respect to thegingival margin area 502 can be made by a variety of methods such aswere discussed above with respect to measurements of the teeth. Thegingival regions can then be included in the digital model and/orsubsequent physical models produced therefrom, with the dimensionsthereof being manipulated in a manner similar to that described withregard to the tooth surface. Therefore, a dental appliance can bescaled-up from the measured dental and gingival surfaces uniformly by aselected percentage, for example, or by some other dimensional increasemethodology to provide a uniform space between the gingival and dentalappliance.

The amount by which a cavity is scaled-up from the correspondinggingival margin area 502 measurements may be the same, or different,than the quantity used to scale-up the cavity with respect to acorresponding tooth structure. Scaling-up the dental appliancedimensions with respect to corresponding gingival margin area 502measurements provides a uniform space therebetween. Such uniform spacecan be arranged and adapted to hold a reservoir of material in contactwith the gingival outer surface to treat periodontal conditions, such asgel, paste, foam, liquid, or powder.

According to one or more embodiments of the present disclosure, alingual pocket 508 and/or a buccal pocket 510 may be formedindependently from any cavity 504 associated with a particular tooth.For example, a lingual pocket 508 and/or a buccal pocket 510 may beformed for a tooth being used as an anchor for the dental appliance witha snug-fitting cavity for receiving the tooth structure.

In some embodiments, the cavity 504 and one or more portions of thelingual and/or buccal pockets 508 and 510 can be sized to fit snuglyagainst the tooth/gingival surface to which they are adjacent. In suchembodiments, the tight fit can be used to hold the appliance in placeand/or to isolate a particular portion of the tooth and/or gingiva.

For example, in some embodiments, the upper portion or both the lingualand buccal pockets 508 and 510 can be sized to fit snugly against thegingival surface to which they are adjacent. The cavity 504 can also besized to fit snugly.

In such an embodiment, the lower portions of both the lingual and buccalpockets 508 and 510 can provide a more loose fitting area into which amaterial may be placed for localized treatment of the lower gingiva(e.g., the gingival margin) and/or the interface between the gingiva 502and the tooth 500. Such embodiments may. for instance, be used where thetreatment material (e.g., chemical solution) is to be concentrated onthe area for a period of time without it seeping into the mouth of thepatient. Such embodiments may also be aided by having the cavity 504 fitsnugly such that little fluid movement is possible into the cavity fromthe looser portions of the pockets 508 and/or 510.

Thus, embodiments of the present disclosure may be configured to onlyprovide periodontal chemical treatment, with or without orthodontictreatment features, and with or without, oversized cavities for chemicaltreatment of tooth structure. Embodiments of the present disclosurecontemplate any combination of these features, alone or in combinationwith one another.

With regard to the chemicals which might be utilized with the devices,systems, and methods of the present disclosure, oral health concernsoften include tooth decay, gingivitis, and periodontitis, to name a few.Tooth decay, for example, may be largely prevented or arrested withfluoride treatment. Treatment materials can include toothpastes, gels,rinses and varnishes.

Gum disease, such as gingivitis or periodontitis, can be caused bybacterial growth associated with dental plaque and calculus deposits.Bacterial growth can be reduced or prevented by mechanically removingthe plaque from the tooth surfaces.

However, chronic gingivitis and tooth decay have plagued manyindividuals who in fact comply with good oral hygiene methods and plaqueremoval. This may be due to a variety of factors including geneticpredispositions, illnesses, mouth breathing, and medical treatmentprograms, among other causes. In such cases, bacterial control may beaccomplished with the use of antibacterial drugs, or other preventionmaterials.

An antibacterial agent that may be effective in reducing the activity ofmany strains of oral flora is chlorhexidine. Chlorhexidine is a cationicbiguanide microbicide with a broad spectrum of activity against manyforms of bacteria and fungi. Therefore it has been a popular agent inmany studies of gingivitis reversal.

Chlorhexidine can be delivered to the oral environment through the useof oral rinses. These rinses provide short term application of thematerial. However, sustained delivery to the gingiva can be accomplishedwith the use of dental appliances according to embodiments of thepresent disclosure.

Another antibacterial agent is tetracycline. Tetracycline is a broadspectrum antibiotic which may be effective against many groups ofpathogenic bacteria, both gram positive and negative.

Tetracycline may be combined with an antifungal agent, such asamphotericin, to provide activity against fungi. Tetracycline may betraditionally been delivered to the oral environment through systemicadministration, although localized delivery can be accomplished usingthe dental appliances of the present disclosure. In addition, a numberof other antibacterial drugs are available for dental and periodontaltherapy, and may be administered locally using one or more of the dentalappliances according to the present disclosure, formed to leave uniform,or non-uniform, space between the dental appliance and a tooth surfaceor teeth surfaces at the targeted point of chemical application.

Cosmetic treatments often include tooth bleaching or whitening andbreath-freshening products. Discolorations of enamel and dentin mayoccur, for example, due to aging, consumption of staining substances(e.g., coffee, tea, colas, and tobacco), trauma staining due to systemictetracycline (antibiotic) therapy, excessive fluoride, nervedegeneration, and old dental restorations, among other causes.

Bleaching lightens these discolorations for a whiter or brighterappearance. A bleaching gel can be provided in the selected oversizedcavities of a dental appliance according to the present disclosure. Thedental appliance fits over the teeth, and can be worn at night, orduring the day. Breath freshening products are often used by patients totreat halitosis or for enjoyment of the taste. These include a varietyof sprays, rinses, mints, gums. or candies, to name a few. Such breathfreshening products can be provided (e.g., formed in or placed) in thedental appliance of the present disclosure.

Many of these therapies utilize access to the teeth and gingival marginwhich are typically covered by the repositioning appliance when in use.In addition, some of these therapies may best be administered bylocalized delivery over extended periods of time which could otherwisecreate substantial interruption of a treatment plan.

For example, low level delivery of antibiotics by sustained releasemethods is often desired to treat periodontal disease. Likewise,treatments such as bleaching and whitening may create an interruption ofthe treatment plan for up to two weeks. Removal of the appliance duringthese periods would lengthen the overall treatment period.

In addition, many of these therapies utilize the usage of specificdevices, gels, rinses, applicators and instructions for eachadministration of therapy. These accessories may be costly, bulky, anddifficult to use.

Although removal of the appliance during treatment should be minimized,it may be necessary to remove the appliance during daily oral hygieneroutines, such as brushing and flossing of the teeth. Likewise. theappliance may be removed from time to time for participation in athleticactivities or for comfort, such as when eating.

FIG. 6 illustrates an example of a dental appliance having one or morescaled-up cavities for selected teeth according to an embodiment of thepresent disclosure. FIG. 6 shows a top view of a patient's dentition fitinto a dental appliance 604 according to one embodiment of the presentdisclosure. Illustrated are one or more treated teeth 600 positionedwithin one or more cavities 614 scaled-up in size by a first percentageand one or more cavities 616 scaled-up in size by a second percentage,the treated teeth 600 having been selected for some form of chemicaltreatment. Other teeth 601 are not being selected to receive theaforementioned chemical treatment. The untreated teeth 601 are shownpositioned within more fitted (e.g., not scaled-up) cavities 612 of thedental appliance 604.

According to various embodiments of the present disclosure, a dentalappliance can be fabricated to provide space over an area associatedwith an erupting tooth which is covered by the gingiva on the jaw, forexample, to reduce mechanical irritation of the area associated withphysical contact of the dental appliance with the gingival. Suchembodiments may permit containment of a chemical to the area, such as apain or inflammation medication, in some instances.

In various embodiments, a computing system can be used in the design ofdental appliances thereof that can be used in association with thefabrication of embodiments of the present disclosure. Such a computingsystem may include one or more computing devices having, for example, aprocessor and memory. The memory can include various types ofinformation including data (e.g., dentition measurement, and/or digitalmodel data) and/or executable instructions to perform the methodsdiscussed herein.

Some embodiments can include a network interface. Such an interface canallow, for example, for processing on another networked computingdevice. Such devices can be used to obtain information about the patientor executable instructions for use with various embodiments providedherein, in some instances.

Various embodiments can include one or more input and/or outputinterfaces. Such interfaces can be used, for instance, to connect thecomputing device with one or more input or output devices. For example,a system may include connectivity to a scanning device, a camera dock, akeyboard, and/or other peripherals.

Such connectivity can allow for the input of image information (e.g.,scanned images and/or digital pictures, etc.), and instructions (e.g.,input via keyboard), among other types of information. Although someembodiments may be distributed among various computing devices withinone or more networks, such systems can be beneficial in allowing for thecapture, calculation, and/or analysis of the various informationdiscussed herein.

Although specific embodiments have been illustrated and describedherein, those of ordinary skill in the art will appreciate that anyarrangement calculated to achieve the same techniques can be substitutedfor the specific embodiments shown. This disclosure is intended to coverany and all adaptations or variations of various embodiments of thedisclosure.

It is to be understood that the use of the terms “a”, “an”, “one orMore”, “a number of”, or “at least one” are all to be interpreted asmeaning one or more of an item is present. Additionally, it is to beunderstood that the above description has been made in an illustrativefashion, and not a restrictive one. Combination of the aboveembodiments, and other embodiments not specifically described hereinwill be apparent to those of skill in the art upon reviewing the abovedescription.

The scope of the various embodiments of the disclosure includes anyother applications in which the above structures and methods are used.Therefore, the scope of various embodiments of the disclosure should bedetermined with reference to the appended claims, along with the fullrange of equivalents to which such claims are entitled.

In the foregoing Detailed Description, various features are groupedtogether in a single embodiment for the purpose of streamlining thedisclosure. This method of disclosure is not to be interpreted asreflecting an intention that the embodiments of the disclosure requiremore features than are expressly recited in each claim.

Rather, as the following claims reflect, inventive subject matter liesin less than all features of a single disclosed embodiment. Thus, thefollowing claims are hereby incorporated into the Detailed Description,with each claim standing on its own as a separate embodiment.

What is claimed:
 1. A dental appliance comprising: a shell having anumber of cavities to receive one or ore teeth, each cavity having aninner surface; and where a particular cavity is scaled-up in size by afirst selected percentage over one or more dimensions of a correspondingtooth surface to provide a uniform space between the cavity innersurface and the corresponding tooth surface, where the particular cavitycontains a chemical to treat the corresponding tooth surface; where atleast a portion of the particular cavity is scaled-up in size by asecond scaled-up percentage that is different than the first selectedpercentage; where the inner surface of the particular cavity hasscaled-up proportions of the dimensions relative to the correspondingtooth surface; and where the first selected percentage is based on oneor more properties of the chemical used to treat the corresponding toothsurface.
 2. The appliance of claim 1, where the particular cavity isscaled-up in size by a selectable percentage from the one or moredimensions to provide a space between an inner surface of the cavity anda corresponding tooth surface.
 3. The appliance of claim 1, includingspacer structures formed into the polymeric shell to offset the innersurface of the scaled-up cavity from a corresponding tooth surface. 4.The appliance of claim 1, where the at least portion of the cavityextends around a gingival margin area supporting a corresponding toothsurface so as to form a pocket of space between the inner surface of thecavity and the corresponding gingival margin area.
 5. The appliance ofclaim 1, where the scale-up of the cavity is in at least one of a buccaland lingual direction.
 6. The appliance of claim 1, where the scale-upof the cavity is on one side of the tooth surface to leave uniform spacebetween the tooth surface and the inner surface of the particularcavity.
 7. The appliance of claim 1, where the particular cavity issized to contain fluoride to treat the corresponding tooth surface, thefirst selected percentage being 1%.
 8. The appliance of claim 1, wherethe particular cavity is sized to contain a whitening agent to treat thecorresponding tooth surface, the first selected percentage being 5%. 9.The appliance of claim 1, where the corresponding tooth surface is abuccal surface.
 10. The appliance of claim 1, where the corresponding,tooth surface includes all accessible surfaces of the correspondingtooth.
 11. The appliance of claim 1, where a second portion of theparticular cavity extends over a corresponding gingival outer surfaceadjacent the corresponding tooth surface thus forming a second uniformspace between a cavity inner surface and the corresponding gingivalouter surface, the second uniform space being contiguous with the firstuniform space.
 12. The appliance of claim 11, where the second portionof the particular cavity extending over the corresponding gingival outersurface is scaled-up in size by a third selected percentage overdimensions of the corresponding gingival outer surface.
 13. Theappliance of claim 11, where the second uniform space is arranged tohold a reservoir of material in contact with the corresponding gingivalouter surface to treat periodontal conditions.
 14. The appliance ofclaim 11, where the second uniform space is arranged to hold materialselected from the group including: gel, paste, foam, liquid, and powder.15. A system of removable dental positioning appliances comprising: aseries of shells adapted to reposition one or more teeth from a firstconfiguration to a successive configuration, each shell having a numberof cavities to receive one or more teeth and each cavity having an innersurface; where a particular cavity is scaled-up in size by a firstselected percentage over one or more dimensions of a corresponding toothsurface to provide a uniform space between the cavity inner surface thatcontains a chemical to treat the corresponding tooth surface; where atleast a portion of the particular cavity is scaled-up in size by asecond scaled up percentage that is different than the first selectedpercentage; where the inner surface of the particular cavity that isscaled-up in size has scaled-up proportions of the dimensions relativeto the corresponding tooth surface; where the first selected percentageis based on one or more properties of the chemical used to treat thecorresponding tooth surface; and where the inner surface of theparticular cavity includes spacer structures to offset the inner surfacefrom the corresponding tooth surface.
 16. The system of claim 15, wherethe one or more properties of the chemical includes a particularviscosity of the chemical, a particular quantity of the chemical, and aparticular form of delivery of the chemical.
 17. The system of claim 15,where the particular cavity is sized to measured dimensions of acorresponding tooth surface.
 18. The system of claim 15, where theparticular cavity scaled-up in size by a first percentage comprises acavity scaled-up in size by the first percentage sized to containfluoride to treat the corresponding tooth surface, the first percentagebeing within a range of 1% to 0%.
 19. The system of claim 15, where theparticular cavity scaled-up in size by a first percentage comprises acavity sized to contain a whitening agent to treat the correspondingtooth surface, the first percentage being 5%.
 20. The system of claim15, where the particular cavity scaled-up in size comprises a cavitythat extends around a gingival margin area supporting the correspondingtooth surface so as to form a pocket of space between the inner surfaceof the cavity and the gingival margin area.